Managing High and Low Blood Sugar

In managing diabetes we need to be proactive, informed, and prepared for both high and low blood sugar events. These fluctuations can impact your day-to-day life, and if not managed well, they can lead to serious complications. Understanding how to detect, treat, and prevent blood sugar swings is essential for maintaining both short-term wellness and long-term health.

In this guide, we’ll walk through everything you need to know about managing high and low blood sugar, and how you can take control with confidence.

 

WHAT IS BLOOD SUGAR AND WHY BALANCE MATTERS

Blood sugar (glucose) is the body’s main source of energy, especially for the brain. It’s regulated by insulin, which helps glucose enter cells for use or storage. Balanced glucose means more energy, clearer thinking, and fewer health risks.

• Normal fasting blood glucose: 70–99 mg/dL
• After meals: typically under 140 mg/dL

Out-of-range blood sugar can lead to:

• Fatigue, headaches, blurred vision
• Cognitive issues and mood changes
• Long-term risks like nerve damage, heart disease, or seizures
  

 

Hyperglycemia (High Blood Sugar)

Hyperglycemia occurs when blood sugar is too high, typically above 180 mg/dL. Untreated hyperglycemia can progress to diabetic ketoacidosis (DKA), a serious and potentially life-threatening condition.

🔍 Common Causes:

• Skipped or incorrect insulin dose
• High-carb meals without proper coverage
• Illness or infection
• Stress or lack of sleep

⚠️ Symptoms Include:

• Increased thirst and urination
• Fatigue or weakness
• Blurred vision
• Headache
• Fruity breath (a sign of diabetic ketoacidosis)

Preventing High Blood Sugar Episodes

• Track carb intake carefully and match insulin accordingly
• Take insulin 10–15 minutes before eating
• Stick to meal plans and avoid high-GI foods in excess
• Stay hydrated and get adequate sleep
• Monitor for patterns and adjust insulin with your care team

Immediate Steps to Take During High Blood Sugar

1. Take a correction dose of insulin (if prescribed)
2. Drink water to help flush out excess glucose
3. Move your body with light activity like walking (if ketones are not present)
4. Check for ketones in urine or blood if your glucose is over 250 mg/dL

If levels remain high for several hours or you have symptoms of DKA, seek medical help.

Hypoglycemia (Low Blood Sugar)

Hypoglycemia happens when blood sugar falls below 70 mg/dL.

🔍 Common Causes:

• Too much insulin or diabetes medication
• Skipping meals or eating too little
• Excessive exercise without proper fueling
• Alcohol consumption without food

⚠️ Symptoms Include:

• Shakiness or trembling
• Sweating
• Confusion or dizziness
• Rapid heartbeat
• Irritability or anxiety

Preventing Low Blood Sugar Episodes

• Never skip meals or snacks
• Adjust insulin before exercise or intense activity
• Consider reduced basal rates during sleep if nighttime lows occur
• Educate those around you in case you need help

Immediate Steps to Take During Low Blood Sugar (Follow the 15-15 Rule)

1. Eat 15 grams of fast-acting carbs (e.g., glucose tablets, juice, candy)
2. Wait 15 minutes and recheck blood sugar
3. Repeat if glucose is still under 70 mg/dL
4. Follow up with a small protein-based snack if a meal is not coming soon

Always carry a fast acting glucose source with you. Severe lows can lead to loss of consciousness or seizures, so immediate action is crucial.

 

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How Stress, Illness, and Hormones Impact Blood Sugar

• Stress hormones (cortisol, adrenaline) increase glucose production
• Illness may cause insulin resistance or lower appetite
• Hormonal cycles impact insulin sensitivity

During these times, test more frequently and work with your care provider to adjust dosing.

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Using a Glucose Monitoring System Effectively

1. CGMs (Continuous Glucose Monitors): Real-time trends and alerts
2. Fingerstick meters: Spot-check accuracy and affordability

When to check for more data = better decisions.

• Before meals
• Two hours after meals
• Before and after activity
• Before bed and upon waking

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How to Adjust Insulin for Glucose Fluctuations

Understand your:

• Insulin-to-carb ratio (ICR)
• Insulin sensitivity factor (ISF)

These help calculate:

• Meal boluses
• Correction doses

Always consult with your endocrinologist before making major insulin changes.

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Exercise: Helping or Hurting Blood Sugar?

Exercise lowers blood sugar, but it can also cause highs or lows depending on timing and type. Fuel properly and have a plan to prevent hypoglycemia.

• Cardio tends to lower glucose
• Intense workouts can spike glucose short-term due to adrenaline
• Always test before, during, and after exercise
  

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Educating Family and Friends on Highs and Lows. Create a simple diabetes emergency plan for school, work, or home.

• How to recognize symptoms
• How to administer glucose or glucagon
• When to call 911

 

Conclusion: Stay Ahead of Highs and Lows with Smart Management

Managing high and low blood sugar is a daily part of diabetes care, but it doesn’t have to be overwhelming. With knowledge, planning, and tools, you can avoid dangerous swings and live confidently. Be proactive, stay consistent, and listen to your body — because when you understand your glucose patterns, you’re always one step ahead.

Interested in how food impacts diabetes management? Check out these popular articles on our blog:

 

• The Mysterious Pizza Bolus—Solved!
• Mindful Eating and Food Choices: Powerful Effects on Physical, Emotional Health & Blood Glucose Management
• How to Bolus and Manage Complex Carbs While Managing Diabetes: Smart Steps for Better Glucose Control

Explore our blog for more tips and resources on diabetes and exercise.